This blog promises to reveal the inside track of a third sector leader influencing in Whitehall, championing professionalism and causing a stir.

Sir Stephen Bubb is CEO of Charity Futures, which promotes better charity governance and leadership. He was formerly Chief Executive of ACEVO (Association of Chief Executives of Voluntary Organisations) until 2016.

His blog is part of the British Library’s national blog archive.

Thursday, 28 August 2014

Winterbourne View, progress

A recent article by my old
friend David Brindle in the Guardian highlighted the problem we face in moving
people with learning disabilities out of hospital into the community and
reflects the background of the work we are doing on a commissioning framework
in our NHS England steering group.

The problem we need to
tackle is that more people with learning disabilities are being placed in
hospitals like the one at the centre of the Winterbourne View scandal than are
being moved out, despite a brave government commitment to move all people out
of inappropriate inpatient facilities. Latest official figures released four
weeks ago show that in the three months to the end of June, 358 people
were admitted to so-called assessment and treatment units in England. Only 261
were discharged.

A subsequent review by the
Government following the scandal concluded that personalised care and
support in appropriate community settings is vital. There is a strong consensus
around that aim. But so far the transfer programme was supposed to have either
moved people out of the units by 1 June or given them a firm date for
discharge. So progress is painfully slow. However much work has gone on and
since taking this area of work on, NHS England has put in place urgent actions
to move towards securing the goals on transfer. I believe we have an
opportunity now to make real progress and secure the community support for
people with learning disabilities that they and families want. The current
system places too much of the power of decision out of the hands of people
with learning disabilities and their families and we need to devise a system
that shifts that power from the state to the citizen. That aim must underpin
our work in devising a new national framework.

The latest figures,
collected by NHS England, show that the number of people given a date for
transfer did double over the three-month period to 577. However worryingly, in
almost four in 10 of these cases, the local councils concerned did not know
that the individuals would be returning to their home communities.

In 50% of all 2,600 cases
– which include 147 children – councils had no idea that they would need to
help make provision for people returning from Assessment and Treatment units. Jan Tregelles, the CEO of Mencap is
quoted in David's article: "We know people with a learning disability need
joined-up local health and social care support. This is clearly not happening.
When this is not in place, people are more likely to end up right back in the
very units they are being moved from."

NHS England has recognised
this and with the steering group I have been asked to chair we are looking at
how a national framework for commissioning and social finance could enable the
build-up of community support. We are reviewing the work that has already gone
on so we can build on that. The aim is "personalised care and support in
appropriate community settings " and a shift to a system that emphasises
citizen rights in the care system. Our last steering group meeting looked at an
initial paper from Bob Ricketts, someone I regard as one of the country's top
experts on commissioning which posed questions we need to consider in
developing our recommendations on commissioning. We also looked at issues
facing a large scale move to community support in the training and development
of the workforce. And shortly an expert reference group on social finance will
meet to examine how to fund community support. And as we committed, we will be
publishing the minutes and papers of the meeting from last week on the NHS
England website.

But this work is one part
of the much wider ongoing system change that is needed. If this is to work in
practice, there needs to be an ongoing engagement and dialogue with the people
with learning disabilities, and their families and carers. Without that, this
simply will not work.

3 comments:

Lots of meetings but no action yet! Claire Dyer's section s due to run out so she asked if she was going to be discharged. Not a hope - they'd already renewed the section without telling her. Still failing!

Please make sure this is financed properly. Doing things on the cheap won't solve problems. Also, so much money gets taken in 'commission' by the middlemen that the pennies spent on the care of the disabled person soon diminish. If councils and governments insisted on proper value for money and followed up on it, there would be less waste within the system. People are going to have to think creatively too if this is going to work. It's too easy sometimes just to fork out for the simple option. That's really why people end up in ATUs and similar places.

Sir Stephen Bubb

About me

Sir Stephen Bubb is globally recognised as a leading voice in philanthropy, charity governance and leadership and corporate social responsibility. He has provided strategic advice to governments and businesses, usually at Prime Minister, Minister, Mayor and Chairman level.

Sir Stephen has taken part in numerous national and global events speaking on civil society, business and government relations, including at the British Cabinet, G7/G8 summits, Seoul Governance Conference and international investment forums. He was formerly Chief Executive of ACEVO (Association of Chief Executives of Voluntary Organisations) for 15 years, and Secretary General of the European Third Sector Leaders Network, which was founded through his passion and drive. He was the Chair of Britain's largest social investment organisation for a decade and oversaw investments of £400m.

He is now CEO of Charity Futures, which promotes NGOs’ governance and leadership. Stephen has received accolades for his work and leadership from former UK Prime Ministers Tony Blair and David Cameron. He was knighted in 2011.